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Please print or type. (Form des,gned for use on 2-pkch)typewriter.) Form Approved.OMS Ab.2050 peas <br /> UNIFORM HAZARDOUS 121.GeneratoesUSEPAIDNo. Manifest Document No 22.Page Information in the shaded <br /> WASTE MANIFEST () areas is not required by Federal <br /> (Continuation Sheet) CALE002738712 of 2 law, <br /> 23.Generator's Name L;State.Mamtest Document Number ' <br /> 0s® ;E DEPOT <br /> M.State Generators ID . <br /> d <br /> 9 5 A=,-nAvem 9;;102 <br /> 24,Transporter Company Name ." A rmns 25.US EPA ID Number N.State Transporters ID <br /> ^.r 0.Transporters Phone,. : <br /> 26.Transporter Company Name 27. US EPA ID Number P.State:Transportees ID' - <br /> 0.Transporter's Phone <br /> 29.Containers 30. 31. R. <br /> 28.US DOT Description(Including Proper Shipping Name,Hazard Class,and ID Number) Total Unit Waste No, <br /> dHM No. T e Ouantity WtlVol <br /> a... <br /> A- I Marv-RCP-,c,, Hazardmus Wase, Sei{d <br /> �J t (s 362. <br /> .. <br /> Ti.b. <br /> LIN325«, Z01 ;Ph arc 1 ':2 D( DF G <br /> C. <br /> r, (R0=1024.),Waste Ci- LiT-ads, Bisic.li mrSsrce, n.c.s.. f1JY <br /> 8, t�iV327s3. PGI{ ('J4S Itdi7 H Tw ' -rtCi "rYtI 12i <br /> a d. - <br /> E /� <br /> N (RQ=10 1,VUa e Co yosire, O fa 5- Ft.a.=., 8, UN30E3, D 1:Dom' <br /> n Poll (S^dium H orite f Eraa� i iERc� L 1 r r, <e ,i�,:1: <br /> A a <br /> fi <br /> ' i� �Pdaa 6> ros�is. Flerrtrnatr9e. 2.4< US�9>� D ,si r '3f�3 <br /> R !&r_ a r. .a c" ifr: .4 "l�-j •,, <br /> h. <br /> L <br /> S:Additional Descriptions for Materials Listed]Above T.Handling Codes for Wastes Listed Above <br /> C Iz+��or,). <br /> t-3Ov Sy IF1 f.c7 <br /> 2331 EE 5x ,-T ,S tit t've i �edt Et 5c7 <br /> 0,151-aE1x SS:A ) <br /> 2sza >=a-4 �. <br /> 32.Special"Handling Instructions and Additional Information <br /> IN CASE OF EMERGENCY, CONTACT 3E AT 80.451.82.441 <br /> tF9f3�."E DEPOT HDfi576 701 [YARCY PARKWAY Ce Aad: $ <br /> EATHROP QA 06330 FwPosa{ 31377 <br /> T 33. Transporter _ Acknowledgement of Receipt,of Materials Date <br /> R <br /> Printed/Typed Name Signature Wonth Day Year <br /> N <br /> S <br /> o 34. Transporter_ Acknowledgement of Receipt of Materials - Date <br /> R PrinledlTyped Name- Signature onth Day- Year <br /> E <br /> R <br /> .- F 35. Discrepancy Indication Space <br /> A <br /> t <br /> L <br /> T <br /> T <br /> Style CF"18 LMF1�IhfTat®(800)62tdB08 ° EPA Form 8700-22A(Rev.9sa)Previous editions are obsolete. <br />